Echocardiographic evaluation of left ventricular diastolic dysfunction in subclinical hypothyroidism: A case–control study. (3rd July 2017)

• Record Type: Journal Article
• Authors: Malhotra, Yuthika; Kaushik, Rajeev Mohan; Kaushik, Reshma
• Is Part Of: Endocrine research. Volume 42:Number 3(2017)
• Page Start: 198
• Page End: 208
• Publication Date: 2017-07-03
• Subjects: Echocardiographic evaluation -- left ventricular diastolic dysfunction -- subclinical hypothyroidism; Endocrinology, Experimental -- Periodicals; Endocrinology -- Periodicals; Endocrinology -- Periodicals; Research -- Periodicals; 616.4
• DOI: 10.1080/07435800.2017.1292524
• Languages: English
• ISSNs: 0743-5800

Abstract

ABSTRACT: Purpose : To study the prevalence of left ventricular diastolic dysfunction (LVDD) in patients with subclinical hypothyroidism (SCH) and the response of LVDD to L-thyroxine therapy.Materials and methods : This cross-sectional case–control study with one longitudinal arm included 67 patients with SCH attending a tertiary care hospital in Uttarakhand, India, and 67 age- and sex-matched healthy controls. LVDD was assessed by 2D, pulsed-wave Doppler (PWD), continuous wave Doppler (CWD), and tissue Doppler echocardiography (TDE). Patients with LVDD received L-thyroxine therapy with reassessment for LVDD 6 months later.Results : SCH patients had a higher prevalence of LVDD than controls (13.43% versus 1.49%; p = 0.017). LVDD showed a significant association with gender ( p = 0.004) and serum FT4 ( p = 0.001). E velocity, E' velocity, A' velocity, iso-volumetric relaxation time (IVRT), E/A, and E'/A' ratios were significantly lower, while A velocity, deceleration time (DT), E/E' ratio, left atrial (LA) volume index, and peak tricuspid regurgitation (TR) velocity were significantly higher in cases than controls ( p < 0.05 each). The E/A ratio correlated significantly with age, serum very low-density lipoprotein (VLDL), triglycerides (TG), thyroid stimulating hormone (TSH), free triiodothyronine (FT3), and high-density lipoprotein (HDL) ( p < 0.05 each). E' velocity correlated significantly with age, serum total cholesterol, VLDL, and TG ( p < 0.05 each), DT with serum total cholesterol ( p = 0.047), and LA volume index with age ( p = 0.021). Age ( p = 0.016) and serum HDL ( p = 0.029) were independent predictors of E/A ratio. Gender was an independent predictor for LVDD ( p = 0.003). Echocardiographic indices for LVDD showed significant improvement after 6 months of L-thyroxine therapy ( p < 0.05 each).Conclusions : LVDD occurs commonly in SCH patients. It can be detected timely using echocardiography and may be reversed by L-thyroxine therapy.